A managed care expert overviews the history, structure, regulation, and issues of the complex US health care system. This second edition work was originally published by Aspen in 2002. Much of the information is distilled from another of the doctor's books, The Managed Care Handbook, 4th ed. An exte
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Most Helpful Customer Reviews
10 of 11 people found the following review helpful:
4.0 out of 5 stars
...well thought out and easy to read.,
By A Customer
This review is from: Managed Care: What It Is and How It Works (Paperback)
The content of the book overall is well thought out and easy to read. Chapter 1, The Evolution of Managed Care, is an excellent chapter. The Medicaid and Medicare sections of Chapter 5 are excellent. Chapter, 7, Quality of Care, is an excellent chapter--one of the best on quality I've read. (reviewed by Carmella M. Sebastian, MD, Senior Medical Director, First Priority Health, The Blue Cross of Northeastern Pennsylvania HMO)
11 of 13 people found the following review helpful:
4.0 out of 5 stars
...covers the basics in an understandable and logical order.,
By A Customer
This review is from: Managed Care: What It Is and How It Works (Paperback)
The book covers the basics in an understandable and logical order...it is well-organized and complete. Chapter 3, The Infrastructure of Managed Care, is very interesting and informative - is very good at describing how managed care organizations do what they do. Chapter 4, Provider Networks, and Chapter 5, Purchasers and Managed Care, are very good chapters with good descriptions of provider networks and purchasing arrangements. (Reviewed by Bernard J. Turnock, MD, MPH, Professor and Director of Community Health Sciences, School of Public Health, University of Illinois at Chicago.)
4.0 out of 5 stars
Covers the basics,
Amazon Verified Purchase(What's this?)
This review is from: Managed Care: What It Is and How It Works (Managed Health Care Handbook ( Kongstvedt)) (Paperback)
This was a requirement for class. It does an excellent job covering the basics but is a very dry read. However, I'm sure it could be worse. The text is easy to understand. The logic the material is presented in is spot on. I recommend reading with a cup of coffee.
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Inside This Book
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First Sentence:
Sometimes cited as the first example of a health maintenance organization (HMO), the Western Clinic in Tacoma, Washington began in 1910 to offer, exclusively through its own providers, a broad range of medical services in return for a premium payment of $0.50 per member per month. Read the first page Key Phrases - Statistically Improbable Phrases (SIPs): (learn more)
other weird arrangement, group health benefits plan, contact capitation, risk for medical expenses, bundled charges, specialty care physician, pharmacy benefits management company, federal qualification, health benefits coverage, clean claim, federal certification, balance billing, provider identifier Key Phrases - Capitalized Phrases (CAPs): (learn more)
Internal Operations, Medicaid Services, Joint Commission, The Managed Health Care Handbook, Aspen Publishers, Health Care Financing Administration, Respondents Rating, Employee Retirement Income Security Act, Own Plan, Blue Cross, Blue Shield, National Provider Identifier, International Classification of Diseases, Industry Report, Competitive Edge, Years Figure, Corporate Compliance Officer Browse Sample Pages:
Front Cover | Table of Contents | First Pages | Index | Back Cover | Surprise Me!
Sometimes cited as the first example of a health maintenance organization (HMO), the Western Clinic in Tacoma, Washington began in 1910 to offer, exclusively through its own providers, a broad range of medical services in return for a premium payment of $0.50 per member per month. Read the first page Key Phrases - Statistically Improbable Phrases (SIPs): (learn more)
other weird arrangement, group health benefits plan, contact capitation, risk for medical expenses, bundled charges, specialty care physician, pharmacy benefits management company, federal qualification, health benefits coverage, clean claim, federal certification, balance billing, provider identifier Key Phrases - Capitalized Phrases (CAPs): (learn more)
Internal Operations, Medicaid Services, Joint Commission, The Managed Health Care Handbook, Aspen Publishers, Health Care Financing Administration, Respondents Rating, Employee Retirement Income Security Act, Own Plan, Blue Cross, Blue Shield, National Provider Identifier, International Classification of Diseases, Industry Report, Competitive Edge, Years Figure, Corporate Compliance Officer Browse Sample Pages:
Front Cover | Table of Contents | First Pages | Index | Back Cover | Surprise Me!
Citations (learn more)
5
books
cite this book:
- Ensuring Fairness in Health Care Coverage: An Employer's Guide to Making Good Decisions on Tough Issues by Matthew K. Wynia MD in Back Matter
- Insurance and Risk Management Strategies for Physicians and Advisors by David Marcinko on page 113
- Far from Home: Father-Daughter Travel Adventures by Wendy Knight in Back Matter
- Bioethics and Public Health Law by David Orentlicher on page 61
- Employee Benefits (6th Edition) by Burton T. Beam Jr. in Back Matter
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